Abstract
We present a possible case of anaphylaxis associated with diclofenac sodium without redness or rash. A 66-year-old woman collapsed at the entrance of our hospital and was immediately treated by an anesthetist on emergency call. The patient was pale, diaphoretic, and incontinent, with impaired consciousness. Positive pressure ventilation was initiated with a resuscitation bag because the patient breathed shallowly and the SpO2 was 80% during transportation to the emergency room. Her condition improved in response to positive pressure ventilation with 100% oxygen. An accompanying family member reported that the patient had numbness of all four extremities and discomfort after taking diclofenac sodium, and impaired consciousness developed. There were no dermal signs, such as redness and rash. However, the symptoms recurred soon thereafter, and the patient was transferred to the medical ward for a suspected diagnosis of anaphylaxis, based on the symptoms and history. Emergency medical care was initiated primarily to save the patient's life. The patient made a full recovery, although difficulty in diagnosis delayed treatment decision-making.
